Kornimate/medical-research-clean huggingface dataset:
effectiveness of modified class iv atraumatic restorative treatment

Conditions: Dental Caries

Summary: atraumatic restorative treatment (art) has become an accepted dental restoration treatment in many developing countries. because, art is intended to be operated in molars, and about 10% of all carious lesion by an age of 18 years appear in anterior teeth in gambia, it was the aim of this study to clinically evaluate a modified art restoration technique for anterior teeth as the traditional treatment approach did not show satisfying clinical results.

atraumatic restorative treatment (art) has become an evidence-based treatment in class i caries cavities for countries with developing dental infrastructure. though epidemiological data also demonstrate restorative treatment needs in anterior teeth in several african countries, scientific evidence for art in this application appeared so far unrewarding. consequently, many carious teeth remain untreated or are scheduled for extraction. in deciduous teeth, class iii and iv art presented 86% failures due to partial or complete loss already within the first year, and longitudinal data in the permanent dentition are rare. survival rates of 71% after three years, and of 68% after six years in the same study cohort were reported from brazil. basically, art appears to be an interesting treatment approach as it combines a manual cavity preparation technique with the use of a glass-ionomer cement as an adhesive and fluoride releasing restoration material. biomechanical stress, however, is above-average in class iv restorations when intending to reconstruct the incisal edge with glass-ionomer cement resulting in reported high rates of restoration fractures or loss. it was therefore the aim to evaluate the clinical effectiveness of a modified art class iv restoration technique in a clinical study. these data are to be compared with an historical control (original art class iv anatomical structure rebuilding restorations). historical control data will be retrieved from "jordan ra, gaengler p, markovic l, zimmer s: performance of atraumatic restorative tratment (art) depending on operator-experience. j public health dent 2010; 70: 176-80."

Eligibility criteria:
inclusion criteria: * informed consent exclusion criteria: * no class iv cavity

Keywords: dentistry dental caries atraumatic restorative treatment effectiveness
transition from alendronate to romosozumab (amg 785)

Conditions: Osteoporosis

Summary: the purpose of this study is to estimate the percent change from baseline in lumbar spine bone mineral density (bmd) following multiple-dose administrations of romosozumab in postmenopausal women with low bmd previously treated with alendronate.


Eligibility criteria:
inclusion criteria: * postmenopausal women, defined as no vaginal bleeding or spotting for ≥ 12 months * low bone mineral density at screening \[defined by a bone mineral density (bmd) t-score ≤ -2.0 and ≥ -4.0 at the lumbar spine (l1 to l4; or bmd t-score of evaluable vertebrae), total hip, or femoral neck\] * currently taking alendronate (70 mg weekly or equivalent) exclusively for ≥ 1 year with verbal agreement that the subject has taken ≥ 80% of their doses with good tolerance exclusion criteria: * history of vertebral fracture, or fragility fracture of the wrist, humerus, hip or pelvis after age 50; or recent bone fracture within 6 months prior to screening * history of metabolic or bone disease such as paget's disease, rheumatoid arthritis, osteomalacia, osteogenesis imperfecta, osteopetrosis, ankylosing spondylitis, cushing's disease, hyperprolactinemia, and malabsorption syndrome * vitamin d deficiency (defined as 25-oh-vitd levels \< 20 ng/ml)

Keywords: amg 785, bone mineral density, alendronate
shock indices use for early mortality from septic shock

Conditions: Septic Shock; Morality

Summary: background and rationale: sepsis is a universal healthcare problem with a high incidence and mortality. improvement in early sepsis recognition and management has reduced the 28 day- and in-hospital mortality in the last two decades. mortality rates from sepsis ranges from 20% to 30% of which one-third occurs within 3 days of icu admission. identifying patients with sepsis or septic shock who are at increased risk of early death can direct the priority of care for these patients and assist in predicting who is most likely to benefit from higher levels of care. in addition, this can encourage for direct future clinical trials to investigate new therapeutic interventions. despite the large body of research on biomarkers (e.g. serum lactate, interlukins) and clinical prediction tools (e.g. msofa score, apache ii) for rapid risk stratification and in-hospital mortality of septic patients, the early identification of patients at increased risk for clinical deterioration remains challenging and the data on predictors of early death in septic patients remains deficient. persistently low map or dap have been related to worse outcomes in septic shock, this was aggravated by the new-onset prolonged sinus tachycardia which occur as a result of sympathetic activity. this associated tachycardia has been linked to increased major cardiovascular events, prolonged length of stay and higher mortality rates the recent study by ospina-tascón et al. presented a novel index, the "diastolic shock index" (dsi), defined as the ratio of heart rate (hr) and diastolic arterial pressure (dap). they studied the diastolic shock index relation to clinical outcomes in patients with septic shock. in their study, this index represented a very early identifier of patients at high risk of death within 28 days and 90 days after admission, while isolated dap or hr values did not clearly identify such risk. a few previous studies focused on the comparison between shock indices for prediction of sepsis outcomes and their results had a preference for dsi and msi over si.in this study we defined early mortality as that will occur within 3 days from admission or start of septic shock. this definition was based on previous works performed in patients with septic shock, for whom trends in organ failures during the first 3 days in the icu were found accurate predictors of outcome . however, almost no study focused on the ability of the diastolic shock index to predict early icu mortality from sepsis within 72 hours from admission. so, this study aims to fill this gap in the literature. objectives : to investigate the ability of the diastolic shock index to predict early icu mortality from sepsis within 72 hours from admission


Eligibility criteria:
inclusion criteria: * adult patients (\>18 years) with septic shock exclusion criteria: * age \< 18 years * arrythmia * history of ischemic heart disease * cardiomyopathy * pregnant women * liver cirrhosis (child b or c) * renal impairment * shock other than septic shock.

Keywords: sepsis early mortality shock indices diastolic shock index
cognitive behavioral therapy for trichotillomania

Conditions: Trichotillomania

Summary: this study aims to develop a comprehensive cognitive behavioral therapy protocol for adult patients with trichotillomania that emphasizes relapse prevention and that addresses comorbid affective symptoms, as well. the study will compare the efficacy of cbt with a minimal attention control (mac)condition. we hypothesize that outcome at post-treatment, 3-month, and 6-month follow-up will be better for the cbt vs. mac condition including higher responder rates and greater reduction in hair pulling severity.

the purpose of this study is to assess the efficacy of cognitive behavioral therapy for patients with trichotillomania. following entry into the study, subjects will be randomized into a cognitive behavioral therapy (cbt) or a minimized attention control (mac) condition. subjects will be assessed with the acceptance and action questionnaire (aaq), the affective regulation rating (arr), the barratt impulsivity scale (bis-11), beck depression inventory (bdi), beck anxiety inventory (bai), clinical global impressions scale (cgi), the difficulties in emotion regulation scale (ders), hair pulling scale (hps), trichotillomania (ttm) impact scale, psychiatric institute trichotillomania scale (pits), national institute of mental health trichotillomania severity scale(nimh-tss), the generalized expectancy for negative mood regulation scale (nmr), the milwaukee inventory for subtypes of trichotillomania- adult version (mist-a), the positive and negative affect scale (panas), the quality of life inventory (qoli), the readiness to change hairpulling behavior (rchpb), the self-esteem scale (ses), the skin picking scale (sps) and the scales of psychological well-being (spwb). subject randomization to a treatment arm will be determined by a random number generator. subject change scores will be assessed for the above scales.

Eligibility criteria:
inclusion criteria: * primary dsm-iv diagnosis of ttm * outpatients who are 18 or older * a minimum mghhps total scale score of 10 * a minimum ttm symptom duration of 1 year with no significant remissions (as defined by complete abstinence of hair extraction for a 2-week period during the prior 6 months) exclusion criteria: * presence of a serious psychiatric condition including mental retardation, psychosis, pervasive developmental disorder, organic mental disorders, manic episode, adhd, suicidality, lifetime alcohol or substance dependence, or alcohol or substance abuse within the past 3 months * presence of a serious medical condition that would limit ability to routinely attend sessions and complete homework assignments * individual or group psychotherapy (not addressing ttm) that has not been ongoing for the past 3 months and/or without intent to continue same treatment during study tenure) * previous cbt for ttm * involvement in other treatment for ttm * psychotropic medication that has not been stable for 3 months prior to study enrollment and/or without intent to continue same medication regimen during study tenure)

Keywords: trich hair pulling cognitive behavioral therapy behavioral therapy
effects of oxytocin on bleeding outcomes during dilation and evacuation

Conditions: Abortion; Dilation and Evacuation; Hemorrhage; Blood Loss

Summary: currently, there is very little research to identify ways to decrease blood loss during d\&e (dilation and evacuation) procedures. the objective is to determine whether routine use of intravenous oxytocin will improve bleeding outcomes at the time of d\&e at 18-24-weeks gestation. to evaluate the hypothesis, investigators will perform a randomized, double-blinded, placebo-controlled trial. the patient will be followed until discharged from the postoperative care unit during which time patient satisfaction, pain score and postoperative bleeding will be assessed.


Eligibility criteria:
inclusion criteria: * requesting pregnancy termination * intrauterine pregnancy at 18- to 24-weeks gestation * gestational-age to be confirmed by ultrasound * patients with fetal anomaly or intrauterine fetal demise that occurred at 18- to 24-weeks gestation * willing and able to understand and sign written informed consents in english or spanish and comply with study procedures exclusion criteria: * ultrasound findings suggestive of placenta accreta * patients requiring preoperative misoprostol
combined hcc-mfccc

Conditions: Liver Carcinoma; Hepatocellular Carcinoma; Cholangiocarcinoma; Surgery

Summary: combined hepatocellular and mass-forming cholangiocarcinoma (chcc-mfccc) is a rare tumor. the aim of this study was the analysis of the outcome comparing such tumor with classic hepatocellular carcinoma (hcc) and mass-forming cholangiocarcinoma (mfccc).

the institutional prospectively maintained database was queried, and 20 patients with chcc-mfccc were identified. a 2:1 match was performed with 40 patients operated in the same period for hcc, and with 40 operated for mfccc. only t1 or t2 patients n0 m0 were considered. primary endpoint was the overall survival (os) and disease-free survival (dfs).

Eligibility criteria:
inclusion criteria: * positive histology for chcc-mfccc, hcc, and mfccc * complete clinical, surgical, pathological and follow-up data. exclusion criteria: * patients preoperatively treated with chemotherapy, radiofrequency ablation or trans-arterial therapies were excluded. * patients operated for recurrent disease and/or with non-radical surgery * patients with missing data were also excluded
act now longitudinal study: outcomes of babies with opioid exposure study

Conditions: Neonatal Opioid Withdrawal Syndrome

Summary: the objective of this longitudinal cohort study is to quantify the effects of antenatal opioid exposure on the trajectory of brain development over the first 2 years of life, examine associations with developmental and neurobehavioral outcomes, and explore how specific factors (differing antenatal and postnatal exposures, severity of neonatal opioid withdrawal, maternal stress/depression/parenting) modify these effects

this objective of this longitudinal cohort study is to prospectively examine the medical, neuroanatomical, neurodevelopmental, behavioral, and social/family/home outcomes of infants who were exposed to opioids in utero. match control infants will be recruited into the study and based on birth hospital and birth month of the exposed infants. the study will quantify the effects of antenatal opioid exposure on the trajectory of brain development over the first 2 years of life, examine associations with developmental and neurobehavioral outcomes, and explore how specific factors (differing antenatal and postnatal exposures, severity of neonatal opioid withdrawal, maternal stress/depression/parenting) modify these effects. the investigators hypothesize that neural connectivity and neuroanatomical volumes are altered by antenatal opioid exposure and that the magnitude of these alterations correlates with developmental and behavioral outcomes. further, maternal and environmental factors interact with antenatal opioid exposure to influence the trajectories of connectivity, development, and behavior over the first 2 years of life.

Eligibility criteria:
inclusion criteria: * exposed infants: born ≥37 weeks gestation with second or third trimester opioid exposure * control infants: born ≥37 weeks gestation with no antenatal drug exposure exclusion criteria: 1. infants with known chromosomal or congenital anomalies potentially affecting the central nervous system 2. apgar score at 5 minutes of \<5 3. any requirement for positive pressure ventilation in the nicu 4. inability to return for outpatient mri and/or follow-up 5. iugr \<3rd percentile 6. heavy alcohol use during pregnancy (8+ drinks per week).

Keywords: nows
evaluation of decreased usage of betablockers after myocardial infarction in the swedeheart registry (reduce-swedeheart)

Conditions: Acute Myocardial Infarction; Non-ST Elevation Myocardial Infarction; ST Elevation Myocardial Infarction

Summary: long-term beta-blocker therapy has not been investigated in contemporary randomized clinical trials in patients with myocardial infarction and normal heart function. the aim of this study is to determine whether long-term treatment with oral beta-blockade in patients with myocardial infarction and preserved left ventricular systolic ejection fraction reduces the composite of death of any cause or new myocardial infarction..

reduce-swedeheart is designed as a registry-based, randomized, parallel, open-label, multicenter trial. patients, day 1-7 after myocardial infarction, who have undergone a coronary angiography and with preserved left ventricular systolic ejection fraction will be randomized to either oral beta-blockade (see "intervention" for detailed description) at a dose according to the treating physician, or no beta-blockade. to allow quick inclusion the randomization module will be accessible by a simple web-based log-in procedure. concomitantly, all baseline data about each individual patient will be collected from the swedeheart registry. patients will then be followed regarding all-cause mortality, myocardial infarction, heart failure, atrial fibrillation, and patient-related outcome measures (for a subgroup of patients). patients that are eligible but not included in reduce-swedeheart will also be followed regarding chosen treatment and the primary and secondary endpoints. follow-up will continue until 379 primary endpoints have been observed (endpoint driven). all analyses will be performed on the intention-to-treat set, defined as all intentionally randomized patients, by randomized treatment. the primary endpoint is death or new mi. information about death will be obtained from the swedish population registry. information regarding new myocardial infarction during hospitalization and readmission because of myocardial infarction or other outcome (secondary outcomes, see section below), will be obtained from the swedeheart-registry (for myocardial infarction) and the patient registry of the national board of health and welfare.

Eligibility criteria:
inclusion criteria: 1. age≥18 years. 2. day 1-7 after mi as defined by the universal definition of mi, type 1, included in the swedeheart registry. 3. undergone coronary angiography during hospitalization. 4. obstructive coronary artery disease documented by coronary angiography, i.e. stenosis ≥ 50 %, ffr ≤ 0.80 or ifr ≤ 0.89 in any segment at any time point before randomization. 5. echocardiography performed after the mi showing a normal ejection fraction (ef≥50%). 6. written informed consent obtained. exclusion criteria: 1. any condition that may influence the patient's ability to comply with study protocol. 2. contraindications for beta-blockade 3. indication for beta-blockade other than as secondary prevention according to the treating physician.
study on clinical features, treatment mode and survival of sarcoma

Conditions: Sarcoma

Summary: the clinical data of all eligible patients who received chemotherapy, radiotherapy, targeted therapy, immunotherapy, interventional therapy and surgery in henan tumor hospital from june 1, 2012 to may 30, 2022 were retrospectively collected.

this study was a single-center retrospective clinical study, which retrospectively collected the clinical data of all eligible patients receiving chemotherapy, radiotherapy, targeted therapy, immunotherapy, interventional therapy and surgical treatment in henan tumor hospital from june 1, 2012 to may 30, 2022. the efficacy, recurrence and survival of various treatments were collected.

Eligibility criteria:
inclusion criteria: no age limit, male or female. a certain subtype of sarcoma was diagnosed by pathology in our hospital. has received at least one hospitalization in this hospital. target lesions can be evaluated according to solid tumor efficacy evaluation criteria (recist; version 1.1) measure diameter changes. complete follow-up data. exclusion criteria: no clear pathology. incomplete follow-up data.
gossypol combined with docetaxel and cisplatin scheme in advanced non small-cell lung cancers with ape1 high expression

Conditions: Non-small Cell Lung Cancer

Summary: the investigators' experimental study found that gossypol was the natural inhibitor of apyrimidinic endonuclease 1 (ape1) and clinical study observed that high expression of ape1 was relative to the platinum-resistance in non-small cell lung cancer. thus the purpose of this study is to find out whether gossypol can improve the sensitivity of cisplatin-based chemotherapy in the non-small cell lung cancer with apurinic apyrimidinic endonuclease 1 (ape1) high expression


Eligibility criteria:
inclusion criteria: * histologic or cytologic diagnosis of nsclc, stage iiib/iv. * males or females between 18 years to 75 years. * no prior cisplatin-based chemotherapy, if the surgery or radiotherapy has been administered, the interval is at least above four weeks. the interval for targeted therapy such as egfr tki is above 2 weeks. * performance status of 0, 1 on the ecog criteria. expected survival is above three months. * at least one unidimensional measurable lesion meeting response evaluation criteria in solid tumors (recist. 2000). * patients can have the brain / meningeal metastasis history, but the metastasis must be treated by operation or radiotherapy), and clinically stable for at least 2 months. * adequate hematologic (neutrophil count \>= 1,500/ul, platelets \>= 100,000/ul), hepatic (transaminase =\< upper normal limit(unl)x2.5, bilirubin level =\< unlx1.5), and renal (creatinine =\< unl) function. * patient compliance that allow adequate follow-up. informed consent from patient or patient's relative. * ape1 ihc (++ or +++). * if female: childbearing potential either terminated by surgery, radiation, or menopause, or attenuated by use of an approved contraceptive method (intrauterine device \[iud\], birth control pills, or barrier device) during and for 2 months after trial. if male, use of an approved contraceptive method during the study and 2 months afterwards. females with childbearing potential must have a urine negative hcg test within 7 days prior to the study enrollment. * no concomitant prescriptions including cyclosporin a, valproic acid, phenobarbital, phenytoin, ketoconazole. exclusion criteria: * inability to comply with protocol or study procedures. * medically uncontrolled serious heart, lung, neurological, psychological, metabolic disease. * second primary malignancy that is clinically detectable at the time of consideration for study enrollment. * pregnant or breast-feeding. * enrollment in other study within 30 days. * brain metastasis with symptoms. * hypokalemic periodic paralysis history.

Keywords: nsclc; gossypol; ape1; chemotherapy
effect of cognitive-behavior therapy on fear responses to body symptoms in patients with panic disorder

Conditions: Panic Disorder With Agoraphobia; Panic Disorder Without Agoraphobia

Summary: the present study aims to investigate a potential mechanism of successful cbt for panic disorder, i.e., the reduction of excessive anxious apprehension and fear responses to panic-related body symptoms in the context of cbt treatment. in the present non-randomized interventional study, effects of cognitive behavior therapy on reported symptoms and fear responses to panic-related body symptoms are investigated. it is expected that symptom improvement during cbt is associated with a decrease in the activation of the brain's fear network to panic-related body symptoms.

changes in fear responses to body symptoms in the course of cbt are investigated in patients with pd by applying a highly standardized hyperventilation task (provoking panic-related body symptoms) prior to and after a manualized cbt or a waiting period. activation of the brain's fear network (defensive activation) is indexed by the potentiation of the startle eyeblink response.

Eligibility criteria:
inclusion criteria: * current primary diagnosis of panic disorder (with or without agoraphobia) as defined by the criteria of the diagnostic and statistical manual, fourth revision/text revision (dsm-iv-tr) (determined using the composite international diagnostic interview and verified by a certified psychotherapist) * age 18 - 65 years exclusion criteria: * current suicidal intent * any psychotic or bipolar disorder * borderline personality disorder * a medical condition that could explain patients' symptoms * physical contradictions regarding application of exposure-based cbt (e.g., neurological disease) * patients has to be on a stable psychopharmacological medication schedule prior to study entry for at least 12 weeks * intake of benzodiazepines